لله الحمد وفقنا لاعطاء التخدير المناطيقي لاحدى الحالات المعقدة في مستشفى الصدر في الجناح العام لمريضة كبيرة في العمر و تعاني من عدة امراض وتعرضت لكسر في عظم العضد وبتوفيق الله خرجت المريضة بسلام .
وان شاء الله نكون في خدمة اهلنا وناسنا في تخدير المرضى للعمليات الصعبة والمعقدة .
An elderly female patient with a upper humerus fracture required regional anesthesia. Because she is a heavy smoker with suspected COPD, a diaphragm-sparing strategy was preferred to minimize the risk of phrenic nerve involvement and respiratory compromise. Therefore, supraclavicular and infraclavicular brachial plexus blocks were selected instead of an interscalene block, which is well known to have a high incidence of hemidiaphragmatic paresis.
Sedation was provided with dexmedetomidine infusion to ensure patient comfort while maintaining preserved respiratory drive. Dexmedetomidine was chosen specifically because it offers cooperative sedation and analgesia with minimal respiratory depression—an important advantage in patients with limited pulmonary reserve.
Throughout the procedure, FiO₂ delivery and SpO₂ were carefully monitored and titrated as necessary. Continuous attention to oxygenation was essential due to the patient’s smoking history, suspected COPD, and the goal of avoiding hypoventilation or desaturation during the block and sedation period.
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1November 1, 2025 3.8K 3
